- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07653737
Immunonutrition for Prehabilitation of Patients With Colorectal Cancer Before Surgery (IMNUTPREH-CRC)
Study of Nutritional Management for Prehabilitation: Surgical and Nutritional Outcomes in Patients With Colorectal Cancer Treated With Oral Nutritional Supplements With and Without Immunonutrition.
Perioperative immunonutrition has been proposed as a strategy to modulate the inflammatory response and improve outcomes after colorectal surgery. However, clinical evidence is heterogeneous, and there are few studies that integrate morbidity outcomes with objective measures of body composition using computed tomography (CT). The objective was to compare immunonutrition versus standard enteral supplementation in surgically treated patients with colorectal cancer, evaluating postoperative complications and changes in body composition.
This study was designed as a 1:1 randomized, open-label, two-arm clinical trial: CONTROL group (standard nutritional oral supplements) and IMMUNONUTRITION (immunonutrition oral supplements). Patients were prescribed these daily oral nutritional supplements at least five days before surgery.
PRIMARY OUTCOME: Post-surgical complications were classified as general and post-surgical; severity was assessed using the Clavien-Dindo classification and global burden with the Comprehensive Complication Index (CCI).
SECONDARY OUTCOMES: Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
Intragroup changes and the percentage of change between groups were compared. An exploratory analysis was performed in patients with sarcopenia defined by SMMI cut-off points.
HYPOTHESIS:
It is expected that preoperative immunotherapy may result in less post-surgical complications and better body composition.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Madrid
-
Madrid, Madrid, Espagne, 28034
- Hospital Universitario Ramon y Cajal
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Patients eligible for colorectal cancer surgery
Exclusion Criteria:
- Non-surgical colorectal cancer
- End-stage liver o kidney disease
- Emergency surgery
- Previous nutritional supplements
- Hypersensitivity to arginine, omega-3, or nucleotides
- Inability for oral nutrition (dysphagia, esophageal/pyloric stenosis)
- HIV infection
- Pregnancy
- Intestinal obstruction
- Active uncontrolled infection
- Dementia, advanced degenerative neurological disease.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Comparateur actif: Control
Standard oral nutritional supplements
|
Oral nutritional supplement with high protein content but not enriched with arginine or any other component of immunonutrition
|
|
Expérimental: Immunonutrition
Oral nutritional supplements with immunonutrition
|
Oral nutritional supplements with immunonutrition (enriched with arginine, nucleotides, vitamin D and omega-3-fatty acid)
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Post-surgical complications
Délai: From surgery until 90 days post-hospital discharge
|
Complications were classified as general and post-surgical; severity was assessed using the Clavien-Dindo classification and global burden with the Comprehensive Complication Index (CCI).
|
From surgery until 90 days post-hospital discharge
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Weight (Kg)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Weight of the patient at each visit
|
From preoperative evaluation until 90 days after hospital discharge
|
|
Height (cm)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Height of the patient at each visit
|
From preoperative evaluation until 90 days after hospital discharge
|
|
BMI (Kg/m2)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Body mass index of the patients calculated using weight and height
|
From preoperative evaluation until 90 days after hospital discharge
|
|
Weight loss (%)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Percentage of weight loss from the preoperative baseline weight of the patient
|
From preoperative evaluation until 90 days after hospital discharge
|
|
MUST (malnutrition universal screening tool) score.
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Nutritional assessment by anthropometric methods including weight, weight loss, height, and body mass index, are used to give the MUST (malnutrition universal screening tool) score.
|
From preoperative evaluation until 90 days after hospital discharge
|
|
Muscle mass - SMMI (cm2/m2)
Délai: From preoperative evaluation until 90 days adter surgery
|
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
|
From preoperative evaluation until 90 days adter surgery
|
|
Psoas muscle index (cm2/m2)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area and index, periabdominal musculature, and fat compartments.
|
From preoperative evaluation until 90 days after hospital discharge
|
|
Subcutaneous fat tissue (cm2)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
|
From preoperative evaluation until 90 days after hospital discharge
|
|
Visceral fat tissue (cm2)
Délai: From preoperative evaluation until 90 days after hospital discharge
|
Body composition was quantified using preoperative and first postoperative CT scans, analyzing skeletal muscle mass index (SMMI), psoas area, periabdominal musculature, and fat compartments.
|
From preoperative evaluation until 90 days after hospital discharge
|
Collaborateurs et enquêteurs
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
- Manifestations neurologiques
- Maladies du système nerveux
- Manifestations neuromusculaires
- Tumeurs par site
- Tumeurs
- Conditions pathologiques, anatomiques
- Maladies intestinales
- Tumeurs gastro-intestinales
- Tumeurs du système digestif
- Maladies du système digestif
- Maladies gastro-intestinales
- Tumeurs intestinales
- Maladies rectales
- Maladies du côlon
- Atrophie musculaire
- Atrophie
- Conditions pathologiques, signes et symptômes
- Signes et symptômes
- Tumeurs colorectales
- Sarcopénie
- Nourriture
- Régime, nourriture et nutrition
- Phénomènes physiologiques
- Nourriture et boissons
- Suppléments alimentaires
Autres numéros d'identification d'étude
- PI118/22
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
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